5 Unhealthy Habits That Could Be Making Your Psoriasis Worse

The obvious signs of psoriasis are on the skin—dry, red patches covered in silver scales. But this chronic autoimmune disease may also put a dent in emotional well‑being and self-confidence, leading some people to make unhealthy lifestyle choices. And it’s a vicious cycle: Many of these bad habits can make psoriasis even worse.

“Lifestyle really can make an impact on the number and severity of psoriasis flares,” says Sandy Skotnicki, M.D., a board-certified dermatologist at Bay Dermatology Centre in Toronto, Canada, and author of Beyond Soap.

Plus, unhealthy habits can increase your risk of heart disease and stroke, which may already be elevated simply by having psoriasis. In fact, people under age 60 with severe psoriasis are more likely to develop heart disease, according to research published in The American Journal of Cardiology. This makes it even more important for people with psoriasis to avoid the following bad habits.

Lack of Exercise

Regular exercise is an important part of any healthy lifestyle—the American Heart Association recommends adults exercise 75 to 150 minutes per week, depending on the intensity level of your workout, for heart health. The bonus is that exercise can also help to boost mood and self-esteem.

“Many patients with psoriasis are reluctant to exercise due to visible lesions or having psoriatic arthritis, but the positive effects are numerous,” Skotnicki says.

She also points out that weight seems to impact the effectiveness of psoriasis medication. “Patients who lose weight appear to have a better response to previously failed medication,” Skotnicki says. “Indirectly, good weight control can decrease the risk of heart disease, high blood pressure, high cholesterol, fatty liver diseases, and diabetes—all of which are made worse by increased inflammation.”

In terms of what type of exercise to do, that’s entirely your choice. Whether it’s walking, running, swimming, dancing or boxing, as long as it gets your heart pounding, it’s fair game. Find something that you enjoy, and it won’t seem like a chore.

Eating Processed or Junk Food

More research is needed, but doctors are starting to realize that diet can impact inflammatory disease. An observational study published by JAMA Dermatology found that people with psoriasis who followed a Mediterranean diet (an eating pattern rich in fruits and vegetables, legumes, whole grains, fish, fruit, nuts, and extra-virgin olive oil) experienced fewer severe flare-ups than those who didn’t.

“This was not proof and only an association, but it is believed that the Mediterranean diet contains many foods that have an anti-inflammatory effect on the body as a whole, which may offer some protection against psoriasis flares,” Skotnicki says.

Dana Marshall, M.D., a board-certified dermatologist at Klinger & Marshall Dermatology in New Orleans, Louisiana, recommends eating foods rich in omega-3 fatty acids like wild-caught salmon, walnuts, and flaxseed, plus a variety of brightly colored veggies and legumes. As much as possible, avoid inflammatory foods like sugar (sucrose), high fructose corn syrup, artificial trans fats (often added to processed foods to extend shelf life), and refined carbohydrates (often found in bread, candy, cookies, cakes, pasta, pastries, some cereals, and soda).

Alcohol

A systematic review published in the Journal of the European Academy of Dermatology and Venereology found a link between alcohol consumption and psoriasis in 18 out of 23 studies. It’s thought that alcohol increases inflammation in the body, which is the last thing someone with an inflammatory condition needs.

“The impact of alcohol on psoriasis is very real,” Skotnicki says. “Limiting alcohol can reduce flares, lower the risk of developing psoriatic arthritis, improve a person’s response to psoriasis medication, and indirectly affect their weight.”

The Dietary Guidelines for Americans 2015-2020 from the U.S. Department of Health and Human Services and U.S. Department of Agriculture recommend that people limit themselves to “moderate drinking,” which is defined as up to one drink per day for women and up to two drinks per day for men. If you’re struggling to keep your drinking at a moderate level, or you have concerns about the role alcohol plays in your life, ask your doctor for help.

Smoking

A review published in May 2016 in Psoriasis: Targets and Therapy found a strong link between smoking and the onset of psoriasis. It’s believed that the chemicals in cigarettes constrict blood flow, putting the body into a state of stress that can lead to a flare. Skotnicki says she’s seen the impact smoking has on psoriasis first-hand in her patients. “Those who quit smoking have fewer psoriasis flares and less hand and foot psoriasis,” she says. “They also can experience long periods of time without psoriasis.”

However, be careful about using a nicotine patch to help you quit. “It’s believed that even nicotine in a patch may cause psoriasis to flare,” Skotnicki says. Ask your doctor to recommend other effective tools instead. Marshall recommends taking smoking cessation classes.

It can be difficult to change long term lifestyle habits, particularly if they’re emotionally driven, such as self-medicating with cigarettes, alcohol, or overeating.

Ava Shamban, M.D., a board-certified dermatologist at Ava MD in Santa Monica, California, suggests making a plan of small changes that are easy to implement. “These need to be something you can continue to do daily, on an ongoing basis, not just a quick fix or from time to time,” she says.

Not Getting Enough Sleep

A study published in Dermatology and Therapy reported data on 3,118 people with psoriatic disease, and discovered that up to 85.4 percent of them report they get poor sleep.

According to Marshall, the main reason for sleep disturbances in people with psoriasis is itch, which can awaken them during the night or prevent them falling asleep in the first place. It can be a vicious cycle: A lack of sleep ramps up stress levels, which can impact the immune system and make psoriasis symptoms even worse.

The National Sleep Foundation recommends sticking to a sleep schedule of the same bedtime and wake up time—even on the weekends—to regulate your body clock and improve sleep quality. It might also help to make bedtime more relaxing, in general, which means avoiding anything that could cause anxiety or stress at night. In the hour before you go to bed, turn off electronics and opt for a more calming activity, like reading a book. Keep your bedroom cool, dark, and quiet.

And speak to your dermatologist if itchiness is keeping you awake. Maybe a different treatment plan can ease your discomfort and help you sleep more soundly.

Taking small steps toward lessening and eventually eliminating these unhealthy habits can go a long way to improving your symptoms.

“Once you are feeling better and seeing changes, you will hopefully be inspired to make even more positive changes and continue on the path,” says Shamban.